Individual
LYNN MACKOVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
245 N 15TH ST, ROOM: 5320 MS: #435, PHILADELPHIA, PA 19102-1101
(215) 762-1179
(215) 762-1051
Mailing address
245 N 15TH ST, ROOM: 5320 MS: #435, PHILADELPHIA, PA 19102-1101
(215) 762-1179
(215) 762-1051
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
NOT YET ISSUED
PA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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